Search

University students may be particularly impacted by the COVID-19 pandemic due to the remote delivery of third level education and lack of peer interaction. This study aims to explore student experiences of COVID-19 in Ireland, in particular experiences of social isolation, stress and adherence to physical distancing guidelines.

Background: The WHO has declared the outbreak of COVID-19 as a pandemic. With no vaccine currently available, using behavioural measures to reduce the spread of the virus within the population is an important tool in mitigating the effects of this pandemic. As such, social distancing measures are being implemented globally and have proven an effective tool in slowing the large-scale spread of the virus. Aim: This scoping review will focus on answering key questions about the state of the evidence on the behavioural determinants of adherence to social distancing measures in research on COVID-19. Method: A scoping review will be conducted in accordance guidelines for best practice. Literature searches will be conducted using online databases and grey literature sources. Databases will include Medline, Web of Science, Embase and PsycInfo, alongside relevant pre-print servers. Grey literature will be searched on Google Scholar. Screening, data extraction and quality appraisal will be conducted independently by two members of the research team, with any discrepancies resolved by consensus discussion and an additional team member if needed. Quality appraisal will be conducted using the Cochrane’s ROBINS-I tool, the Cochrane Risk of Bias tool, and the JBI Critical Appraisal Checklist where appropriate. Results will be analysed by mapping findings onto the Theoretical Domains Framework and visualising characterisitcs of the included studies using EviAtlas. Conclusion: The results of this study may facilitate the systematic development of behavioural interventions to increase adherence to social distancing measures.

Background: Despite representing the highest level of total population mental health burden, young people are the least likely to seek help from mental health services. It has been suggested that service design can influence the likelihood that young people will look for help, but little is known about how young people would like a service to be designed. This study addresses a gap in research regarding how mental health services can be designed to facilitate access for young people. Methods: A collective intelligence, scenario-based design methodology was used to facilitate stakeholders to identify and prioritise ways to improve youth mental health services. In total, 74 15–17-year-olds from three geographically diverse schools in Ireland worked to identify barriers to help-seeking and to generate and prioritise options in response to barriers. Nine practitioners with experience of working in youth mental health services rated all options in terms of both potential impact on help-seeking and feasibility for service implementation. Results: A total of 326 barriers across 15 themes were generated by youth stakeholders, along with 133 options in response to barriers. Through a process of voting, young people identified 30 options as the most impactful for improving access to mental health services. Of these options, 12 were also rated by practitioners as having both high potential impact and high feasibility. These 12 options focused on four areas: making services more familiar and welcoming; providing specialist mental health input in schools; improving parental understanding; and improving the visibility of appropriate supports. Conclusions: The results of the current study inform mental health service innovation and development, in particular, by highlighting potentially impactful and feasible ways to adapt existing mental health services to improve young people’s help-seeking behaviour.

Optimising public health physical distancing measures has been a critical part of the global response to the spread of COVID-19. Evidence collected during the current pandemic shows that the transmission rate of the virus is significantly reduced following implementation of intensive physical distancing measures. Adherence to these recommendations has been poorer than adherence to other key transmission reduction behaviours such as handwashing. There are a complex range of reasons that are likely to predict why people do not or only partially adhere to physical distancing recommendations. In the current project we aim to address the following research questions: (1) What are the psychosocial determinants of physical distancing for the general public and for key socio-demographic sub-groups (e.g., young adults, older adults, etc.)?; (2) Do current Government of Ireland COVID-19 physical distancing communications address the determinants of physical distancing?; and (3) How can communications be optimised and tailored to sub-groups to ensure maximum adherence to guidelines? These will be addressed by conducting three work packages (WPs). In WP1, we will work closely with the iCARE international study, which includes a large online survey of public responses to measures established to reduce and slow the spread of COVID-19, including physical distancing. We will analyse Irish data, comparing it to data from other countries, to identify the key psychosocial determinants of physical distancing behaviour. This will be followed by a qualitative study to explore in depth the barriers and facilitators of physical distancing behaviour among the Irish public (WP2). In WP3, we will conduct a content analysis and evidence mapping of current government messaging around physical distancing, to ensure the findings from this research feed into the development of ongoing communication and future messaging about physical distancing.

Background: The WHO has declared the outbreak of COVID-19 as a pandemic. With no vaccine currently available, using behavioural measures to reduce the spread of the virus within the population is an important tool in mitigating the effects of this pandemic. As such, social distancing measures are being implemented globally and have proven an effective tool in slowing the large-scale spread of the virus. Aim: This scoping review will focus on answering key questions about the state of the evidence on the behavioural determinants of adherence to social distancing measures in research on COVID-19. Method: A scoping review will be conducted in accordance guidelines for best practice. Literature searches will be conducted using online databases and grey literature sources. Databases will include Medline, Web of Science, Embase and PsycInfo, alongside relevant pre-print servers. Grey literature will be searched on Google Scholar. Screening, data extraction and quality appraisal will be conducted independently by two members of the research team, with any discrepancies resolved by consensus discussion and an additional team member if needed. Quality appraisal will be conducted using the Cochrane’s ROBINS-I tool, the Cochrane Risk of Bias tool, and the JBI Critical Appraisal Checklist where appropriate. Results will be analysed by mapping findings onto the Theoretical Domains Framework and visualising characterisitcs of the included studies using EviAtlas. Conclusion: The results of this study may facilitate the systematic development of behavioural interventions to increase adherence to social distancing measures.

Additional file 1. COREQ checklist.

To explore the parental impact and experiences of caring for a child with Down’s arthritis (DA), an aggressive, erosive form of arthritis affecting children with Down syndrome. Ten mothers of children with DA were interviewed via telephone. Interviews were guided using a semi-structured non-directive topic guide and ranged from 17 to 242 minutes in duration. Interpretative phenomenological analysis was the method of analysis. Three superordinate themes were identified: “Struggle for Help,” “Mothers Know Best,” and “Daily Impacts.” Common challenges included issues around child pain, communication, and challenges in accessing diagnoses and relevant healthcare services. Parents portrayed a reality characterised by ongoing struggles, particularly parents of nonverbal children and those living further from paediatric rheumatology services. Connecting with other parents of children with DA provided a vital source of emotional and informational support. Findings provide novel insight into the experience of being mother of a child with DA, highlighting regional healthcare disparities, the need for upskilling of healthcare professionals, and for increased public awareness. Further research is needed to better understand the impact of DA on fathers and siblings. Findings can contribute to development and provision of supports to children with DA and their families.Implications for RehabilitationHealthcare professionals need to be upskilled in the treatment of, and communication with, children with Down syndrome with chronic illnesses and their families.A specialised stream of care for children with Down’s arthritis (DA) within paediatric rheumatology services may facilitate timely diagnosis and treatment and minimise risk of future complications.Formalised support services for children with DA and their families are needed to minimise emotional distress. Healthcare professionals need to be upskilled in the treatment of, and communication with, children with Down syndrome with chronic illnesses and their families. A specialised stream of care for children with Down’s arthritis (DA) within paediatric rheumatology services may facilitate timely diagnosis and treatment and minimise risk of future complications. Formalised support services for children with DA and their families are needed to minimise emotional distress.

Background: Resistant hypertension is a chronic condition in which the arterial blood pressure remains persistently above goal despite concurrent treatment with three or more antihypertensive agents of different classes. It appears relatively common in clinical practice, despite the established effectiveness of antihypertensive medications. Clinical factors such as inadequate dosing of antihypertensive medications, white coat hypertension (the phenomenon in which blood pressure is higher in clinical settings versus other settings), improper blood pressure measurement, and poor adherence to antihypertensive treatment all preclude a diagnosis of resistant hypertension. Poor adherence is considered the most common cause of pseudo-resistance to treatment among patients with apparent treatment-resistant hypertension and can result in unnecessary treatment escalation and referral to specialist hypertension clinics at significant cost to the patient and the healthcare system. Despite forming a core component of the definition and diagnosis of resistant hypertension, the extent, predictors and patient perspectives of non-adherence have not been extensively examined for this group. Aim: The aim of this research is to examine the extent, theoretical predictors, and patient perspectives of non-adherence to antihypertensive medications for apparent treatment-resistant hypertension in primary care. Methods: This research comprised: (1) a systematic review and meta-analysis to examine the extent of medication non-adherence in the published literature, and the study-level predictors thereof; (2) a quantitative cross-sectional study to examine the extent of poor adherence among a large sample of patients with apparent treatment-resistant hypertension receiving treatment in primary care using multiple diverse adherence measures, as well as the predictive value of theoretical constructs drawn from the Common-Sense Model of Self-Regulation (i.e., treatment-favourable beliefs, coherence of beliefs resulting from experience with treatment, and medication-taking habit strength); and (3) a qualitative comparison of high and low adherers to delineate factors associated with good and poor adherence using thematic analysis. Findings: (1) The systematic review and meta-analysis revealed that approximately one-third of patients classed as having apparent treatment-resistant hypertension in the published literature may be more appropriately classed as pseudo-resistant due to poor adherence. Subgroup analysis further revealed that adherence estimates were dependent on the type of adherence assessment method used, with the highest non-adherence observed for physical tests for medications in bodily fluids. There was a small but significant difference in adherence estimates across study settings, with lowest non-adherence estimates observed in primary care settings, suggesting that a proportion of patients may be prematurely referred for specialist treatment without adequate assessment of adherence in primary care. (2) The cross-sectional quantitative study indicated that, even among a single sample of participants, the measure used to assess adherence has a considerable impact on the adherence estimates obtained. Habit strength was demonstrated to be the strongest predictor of adherence behaviour across all analyses. Treatment-related beliefs and coherence of beliefs did not predict adherence, even for patients with relatively weak habits. Treatment burden was also not associated with adherence or habit strength for this sample. (3) The qualitative comparison of high and low adherers identified that illness- and treatment-related beliefs, coherence of beliefs, and medication-taking habits are all important factors in determining whether a patient will adhere to treatment. Most patients described the important role of the general practitioner in promoting good adherence, but highlighted system-related factors as potentially diminishing people’s confidence in their care. Overall differences between high and low adherers were subtly nuanced, highlighting the challenges for healthcare practitioners in clearly identifying poor adherence and potential determinants. Conclusion: The findings of this research provide important new insights into adherence among patients with apparent treatment-resistant hypertension. The quantification of the problem of non-adherence and identification of methodological limitations in the existing literature, quantitative examination of theoretical predictors of adherence, and qualitative investigation into characteristics of high and low adherers with apparent treatment-resistant hypertension together contribute to the evidence base for the development of targeted behavioural interventions to promote antihypertensive adherence in primary care.